Financial Assistance

Cottage Health’s mission is to provide superior health care for and improve the health of our communities through a commitment to our core values of excellence, integrity and compassion.

As part of this mission, Cottage Health is pleased to offer a financial assistance program to patients unable to pay for emergency or medically necessary care.

Eligibility

Patients are eligible for a complete write-off of their medical bills (out-of-pocket portion only) if their family income does not exceed 400 percent of the federal poverty level. Patients whose family income is higher than 400 percent of the federal poverty level may be eligible for a discount. To determine eligibility, we ask for a completed Financial Assistance Application.

When a completed Financial Assistance Application is received, the patient/guarantor will be contacted by phone or email as a courtesy notification of our receipt. All accounts listed on the application will be placed on a temporary hold from the billing cycle, pending a final decision.

The application will be reviewed and a final determination letter will be mailed with an updated status within 14 business days from receipt. If additional documentation is needed, the patient/guarantor will be notified.

Financial Assistance Application Documents

To apply for financial assistance, please complete the application in your preferred language. The Cottage Health Business Office is available to assist with the completion of Financial Assistance Applications Monday through Friday between the hours of 8 a.m. - 4 p.m. You may also call to schedule an appointment at 805-879-8963.

English

• Financial Assistance Application
• Plain Language Summary
• Financial Assistance Policy
• Amounts Generally Billed

Español (Spanish)

• Solicitud de Asistencia Financiera (Financial Assistance Application)
• Resumen en Lenguaje Claro (Plain Language Summary)
• La política de asistencia financiera de Cottage Health (Financial Assistance Policy)
• Base para calcular las cantidades que se cobran a los pacientes (Amounts Generally Billed)

Tagalog (Tagalog)

• Aplikasyon sa Tulong Pinansyal (Financial Assistance Application)
• Buod ng Plain Language (Plain Language Summary)
• Patakaran sa Tulong na Pampinansyal para sa Pasyente (Financial Assistance Policy)
• Mga Karaniwang Nasingil (Amounts Generally Billed)

漢語 (Mandarin)

• 財務援助申請表 (Financial Assistance Application)
• 财务援助政策 简明概要 (Plain Language Summary)
• 財務援助政策 (Financial Assistance Policy)
• 一般計費金額 (Amounts Generally Billed)

Other Ways to Request Documents

To request a copy of Cottage Health’s Financial Assistance Application, Policy, Plain Language Summary or Amounts Generally Billed summary, please call, email, mail or visit us:

Phone: Cottage Health Business Office, (805) 695-2518 (Phone hours: 8 a.m. - 6 p.m., Monday–Friday)

E-mail: CottageBilling@sbch.org

Mail: Cottage Health, Attention: Financial Assistance Program, P.O. Box 689, Santa Barbara, CA 93102

Online: Follow this link to download and print the Cottage Health Financial Assistance Application

In Person: Any of our Cottage Health Emergency Departments, or the Business Office:

• Santa Barbara Cottage Hospital | 400 W. Pueblo Street, Santa Barbara, CA 93105 | (805) 682-7111 extension 53692
• Goleta Valley Cottage Hospital | 351 S. Patterson Avenue, Santa Barbara, CA 93111 | (805) 967-3411 extension 66484
• Santa Ynez Valley Cottage Hospital | 2050 Viborg Road, Solvang, CA 93463 | (805) 688-6431 extension 74800
• Cottage Health Business Office | 6550 Hollister Avenue, Goleta, CA, 93117 | Office hours: 8 a.m. - 4 p.m., Monday - Friday.

Confidentiality: We are committed to maintaining the confidentiality of requests, information and funding. The information requested in the Financial Assistance Application is for the sole purpose of financial assistance. We DO NOT share information with any third parties, federal or local government agencies.